Functional chest pain: Nociception and visceral hyperalgesia

Premjit S. Chahal, Satish S.C. Rao

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Functional chest pain is a common, yet poorly understood entity. The focus of this review is to explore the evolving research and clinical approaches with a particular emphasis on the sensory or afferent neuronal dysfunction of the esophagus as a key player in the manifestation of this pain syndrome. Although once regarded as a psychologic or esophageal motility disorder, recent advances have shown that many of these patients have visceral hyperalgesia. Whether visceral hypersensitivity is a central or peripheral perturbation of the gut-brain axis remains debatable. Response to empirical therapy with high-dose proton pump inhibitors, upper endoscopy, or prolonged recording of esophageal pH may identify gastroesophageal reflux disease as a source of chest pain. Esophageal balloon distension study can serve as a useful test for identifying hypersensitivity. Newer techniques, including functional magnetic resonance imaging, magnetoencephalogram, and cortical evoked potentials, are being investigated. High doses of proton pump inhibitors and low doses of tricyclic antidepressants or trazadone remain the mainstay of therapy, although several new approaches including theophylline have been shown to be beneficial.

Original languageEnglish (US)
Pages (from-to)S204-S209
JournalJournal of Clinical Gastroenterology
Volume39
Issue number5 SUPPL. 3
DOIs
StatePublished - May 1 2005
Externally publishedYes

Fingerprint

Nociception
Proton Pump Inhibitors
Hyperalgesia
Chest Pain
Hypersensitivity
Esophageal Motility Disorders
Esophageal pH Monitoring
Tricyclic Antidepressive Agents
Theophylline
Gastroesophageal Reflux
Evoked Potentials
Esophagus
Endoscopy
Magnetic Resonance Imaging
Pain
Brain
Therapeutics
Research

Keywords

  • Nociception
  • Noncardiac chest pain
  • Treatment
  • Visceral pain

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Functional chest pain : Nociception and visceral hyperalgesia. / Chahal, Premjit S.; Rao, Satish S.C.

In: Journal of Clinical Gastroenterology, Vol. 39, No. 5 SUPPL. 3, 01.05.2005, p. S204-S209.

Research output: Contribution to journalArticle

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